Echocardiographic assessment in patients with atrial fibrillation (AF) and normal systolic left ventricular function before and after catheter ablation: If AF begets AF, does pulmonary vein isolation terminate the vicious circle?

Özbay²,

et al. 2020

Kardiol Pol

the primary cause of thromboembolism. 5,6 Together with LA thrombus, moderate or severe SEC forms the thromboembolic milieu. 7,8 Routine identification of LA thrombus and / or SEC is generally difficult, as it requires semi -invasive procedures, such as transesophageal echocardiography (TEE). The current guidelines on the management of AF recommend the CHA 2 DS-2 VASc score (congestive heart failure, hypertension, age ≥75 years, diabetes, history of stroke IntroductIon Atrial fibrillation (AF) is the most common cardiac arrhythmia in clinical practice, and its thromboembolic complications can cause significant morbidity and mortality. [1][2][3] Therefore, the evaluation of thromboembolic risk and the administration of anticoagulant therapy based on this risk are crucial. 4 In AF patients, left atrial (LA) thrombus and spontaneous echo contrast (SEC), a swirling echo density in the LA and its appendage, constitute

Section: Methods Patient Selection and Study Designmentioning

confidence: 99%

A new risk model for the evaluation of the thromboembolic milieu in patients with atrial fibrillation: the PALSE score

Özbay²,

et al. 2020

Kardiol Pol

“…после КА независимо от ритма во время исходного обследования, что доказывает влияние РЧА ФП на оба предсердия. Но в данной работе нет информации о механической способности предсердий в раннем послеоперационном периоде [13].…”

Section: результаты и обсуждениеunclassified

Effect of catheter ablation for atrial fibrillation on left and right atrial function

et al. 2022

Aim. To evaluate the effect of catheter ablation on left (LA) and right atria (RA) function in patients with atrial fibrillation.Material and methods. The study included 28 patients (14 men and 14 women) aged 33 to 72 years (mean age, 57,7±9,9 years) with paroxysmal (n=23) and persistent AF (n=5). All patients underwent radiofrequency ablation (RFA) with pulmonary vein antrum isolation. Before ablation and 3 days after, transthoracic twodimensional echocardiography was performed in sinus rhythm with an assessment of LA reservoir, conduit and booster pump function and RA peak longitudinal strain.Results. In the studied patients, a significant decrease in the reservoir, conduit and booster pump function of the LA was revealed after RFA, while there was no significant change in RA peak longitudinal strain after catheter ablation. LA reservoir, conduit and booster pump function decreased by 6,45% (p<0,001), 3,59% (p<0,001), 2,85% (p<0,001), respectively, while RA peak longitudinal strain increased by 0,73% (p=0,43).Conclusion. Catheter ablation has a significant damaging effect on the LA tissue, inhibiting the reservoir, pumping and pipeline functions. At the same time, the contractility of the PP in the early postoperative period improves, but not significantly.

Cardiology Research and Practice

“…It is associated with significant cardiovascular morbidity and mortality, and it produces immense health care costs. Future projections show a further increase in the prevalence of AF [ 4 , 5 ]. A possible reason for the increasing prevalence might lie in the growing elderly population and/or a higher proportion of the population with other chronic diseases.…”

Section: Introductionmentioning

confidence: 99%

“…The correlation between certain echocardiographic parameters and AF recurrence after CA is well implemented, specifically: atrial size, LVEF, LV diastolic dysfunction, LA strain, left atrial mechanical dyssynchrony, and functional mitral regurgitation [ 5 , 16 ]. However, data on the role of MAPSE in AF and postablation prediction is scarce.…”

Section: Introductionmentioning

confidence: 99%

Mitral Annular Plane Systolic Excursion (MAPSE) as a Predictor of Atrial Fibrillation Recurrence in Patients after Pulmonary Vein Isolation

Alatic

Suran

Vokac

et al. 2022

Introduction. Catheter ablation (CA) with pulmonary vein isolation (PVI) has become widely used in the past years for the treatment of atrial fibrillation (AF). Mitral annular plane systolic excursion (MAPSE) is the parameter that measures left ventricular longitudinal function, and it appears to be a good early marker of LV dysfunction. It is practically independent of poor image quality. The aim of our study was to analyse the role of echocardiographic variables, especially MAPSE in predicting the outcome of CA in patients with AF. Materials and Methods. We prospectively included 40 patients with paroxysmal and persistent AF that were referred for CA. All patients underwent radiofrequency CA with PVI. Standard transthoracic two-dimensional echocardiography was conducted one day after CA. Demographic data and the patients’ characteristics were noted. The endpoint of our study was to estimate the AF recurrence rate diagnosed by ECG within 6 months of the follow-up period. Results. 40 patients, mainly male (67.5%) with an average age of 61.43 ± 8.96 years were included in our study. The majority of patients had paroxysmal AF prior to ablation (77.5%). The AF recurrence rate was 20% after 6 months of follow-up. Lateral MAPSE in the AF-free group was greater than those who relapsed (1.57 ± 0.24 vs. 1.31 ± 0.25; p = 0.012 ). Patients who remained AF-free after a 6-month follow-up period had a significantly smaller left ventricular volume index (LAVI) than those who relapsed (34.29 ± 6.91 ml/m2 vs. 42.90 ± 8.43 ml/m2; p = 0.05 ). We found a significant reverse relationship between LAVI and MAPSE ( p = 0.020 ). Conclusion. MAPSE and LAVI present risk factors for AF recurrence, specifically reduced MAPSE and larger LAVI, are related to AF recurrence after CA. In the future, MAPSE could play a significant role when predicting the CA outcome in patients with AF.